Liver cancer is the fourth-leading cause of cancer death in the world. Surgery is one treatment option for liver cancer, although thermal ablation which uses heat to destroy the cancerous tumor has less complications and a quicker recovery time. It can also be performed on patients who are not fit for surgery due to some reasons. However, thermal ablation requires precise needle placement to treat the cancer without damaging the vital organs and blood vessels surrounding it. Now, a new system that uses ultrasound to construct 3D-images could increase the accuracy of thermal ablation for treating liver cancer.

Generally, ultrasound or CT (computerized tomography) imaging is used to guide needle placement, although both are limited. Although ultrasound is widely available and can be performed in real-time, it delivers only 2D images. On the other hand, a CT scan generates 3D images, but not in real time and is a lengthy process. In order to create 3D ultrasound images, the new system uses a robotic cradle to move a standard ultrasound probe, collecting images and stacking them like puzzle pieces. In a simulated study, researchers at Western University (Ontario, Canada) and Lawson Health Research Institute (Ontario, Canada) used data from 14 patient cases to analyze the technology’s accuracy. They found that with standard imaging, there was complete tumor ablation in 64.3% of cases, while the new system offered complete coverage for 92.9% of cases (13 out of 14 cases). They found that in the one remaining case, the patient could benefit from increased ablation time or intensity. If the robotic ultrasound system proves to be effective, then its portability could enable more widespread use of 3D ultrasound imaging, such as in smaller health care centers. Additionally, it could also reduce imaging wait times by eliminating the need for CT scans.

“We developed a new 3D ultrasound method that shows promise in analyzing whether the complete liver tumor will be ablated by the procedure,” explained Aaron Fenster, professor at Schulich Medicine & Dentistry and scientist at Robarts Research Institute. “And we’re now using the same system to guide the needle directly into the centre of the tumor.” 

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